According to the Acceptance and Commitment Therapy theory, WHAT are the core concerns or struggles for the following case study conceptualization and WHAT has contributed to those concerns arising?

Identification: Case Presentation

Name: Dil Lila

Age: 18

Sex: Female

Race/Ethnicity: Indian

Relational Status: Single Informants: Client, Client's mother, sister, school counselor Referral: Family referral

Presenting Problem:

Dil Lila is a senior valedictorian with a full academic scholarship to Stanford University. candidate that is experiencing anxiety, depression and panic attacks (overwhelm). Her recent symptoms are all due in part to her recent discovery that she is 2 months pregnant and does not know 'who' the father is between a former boyfriend and current boyfriend.

Description of Problem in terms of Thoughts, Feelings, Behaviors, Bodily Symptoms

Dil Lila indicates she is thinking about a possible abortion, considering keeping the baby and giving it up for adoption or possibly considering suicide.

Dil Lila has not disclosed anything to family or friends as she recently found out and is in a panic. She has isolated herself and is staying home as if she is in a cocoon. She has begun a cycle of negative self-talk that she is a horrible person, and she will be a huge disgrace to the family.

Dil Lina has begun having morning sickness, nausea and general weakness. She is scared someone is going to find out about her secret and furthermore, she does not even know 'who' to tell in terms of her boyfriends for potential support.

Interpersonal Relationships

Both her sister and her mother report that their once 'bright and spright' spark of light has entered a deep depression, and they are very worried for her. Dil Lila was the center of the social scene and is now nowhere present in any social settings. Classmates are starting to talk and worry. Her teachers are starting to report to the school counselor that they have noticed distinct changes in behavior such as complete withdrawn and disinterest or participation in the classroom.

Developmental and Family History:

Dil Lila is 18 months apart from her older sister. She thinks her older sister looks like a super model and is very insecure around her. Her father is deceased for three years. Her mother brought her and her sister with their aunt and uncle and 2-year old baby from India to America. They are low-middle class. Her mother is the head manager at the local Kroger and works long hours and 'off' hours. She is not that present or available. Her aunt and uncle who live upstairs in a separate unit do not converse with her much. All she feels she has is her sister to talk to. With her current condition, she does not even want to speak with her sister because of the strict, traditional upbringing. She does not want to bring her family reputable shame amongst the Indian populace.

Medical Conditions and Previous Counseling.

None

Social History:

A social butterfly and class leader, Dil Lila is experiencing extreme embarrassment and shame.

Her isolation is creating a plethora of messages and phone calls that she knows she cannot ignore for much longer.

Everyone knows she is with the star athlete at school in which rumors are starting to circulate. Furthermore, she does not think it is his child.

Substance Use and Legal Involvement:

Dil Lila does partake in social gatherings and has been know to succumb to the pressures of school to succeed (to escape low-class) and drink alcohol and smoke marijuana.

Cultural Context/Identity:

Dil Lila was born and raised in India and are of Muslim faith. Since moving to America, she has expressed her disinterest in the religion and is being ridiculed by her aunt and uncle in the household.

Assets:

With a 36 on her ACT and full-academic scholarship to Stanford University, her future is looking very bright. She has excelled academically and is now faced with a serious dilemma.